Objectives Most cases of pediatric scalp and skull masses are either congenital or developmental tumors or diseases, and in many patients, these lesions are accompanied by intracranial extension. Past studies pertaining to these conditions are few, and thus clinical information is as yet inadequate. Materials and methods The authors present 75 pediatric patients with 77 cases of surgically treated scalp and skull masses. The most common pathologic condition was Langerhans cell histiocytosis, followed by epidermal cysts, epidermoid and dermoids, scalp hemangiomas, and neurofibromas, in descending order. Intracranial extension was observed in three cases (4%); two cases were malignant tumors that were skull metastasis of a neuroblastoma and a lymphoma, and one case was encephalocele. Lesions followed up because of possible recurrence were 15 cases of Langerhans cell histiocytosis, eight cases of epidermoid and dermoids, two cases of malignant tumors, and one case each of desmoplastic fibroma, myxoma, fibroid dysplasia, and neurofibroma, totaling 29 cases (39%). Conclusion Although the overall incidence of intracranial extension of pediatric scalp and skull masses is very low and the presence of a malignant tumor or metastatic tumor presenting as a scalp and skull mass is rare, such masses enlarge as time progresses, and there exists a possibility of recurrent disease. Therefore, it is suggested that early surgical resection will afford favorable prognosis for the patients, and meticulous follow-up is necessary in some conditions.
ObjectiveTo evaluate the radiographic and clinical outcomes of percutaneous vertebroplasty (PVP) in patients with Kümmell's disease.MethodsA retrospective review was conducted for 19 vertebrae in 18 patients, between January 2012 and June 2016. A visual analogue scale (VAS) score was used to determine each patient's subjective level of pain (0=no pain to 10=severe pain) preoperative, immediately postoperative and at the last follow-up (at least 12 months after PVP).Radiographic parameters such as regional and global kyphotic angle, lumbar lordosis (LL), thoracolumbar junction (TLJ) angle, vertebral height, cement leakage, refracture, and adjacent level fracture were evaluated by the clinician preoperative, immediate postoperative and at the last follow-up.ResultsThe mean VAS score significantly decreased after PVP and the decrease was maintained through to the final follow-up (p<0.05). However, the regional and global kyphotic angle, LL, and TLJ angle were not improved. Cement leakage was observed in 5 cases (26.3%): however, there were no cases of cement leakage into the spinal canal. No neurological deterioration was observed, even among patients with cement leakage. Adjacent level fractures were detected in 3 cases (15.8%).ConclusionPVP can be considered as an effective treatment option for pain relief and maintenance of sagittal balance in patients with Kümmell's disease.
ObjectiveSymptoms of posterior reversible encephalopathy syndrome (PRES) include headache, altered mental status, visual disturbances, and seizures. Typical radiological features include edema of the parieto-occipital lobes. The purpose of this study is to review the clinical and radiological findings in patients diagnosed with PRES.MethodsAll patients diagnosed with PRES between January 2006 and December 2012 were retrospectively included in this study. We reviewed demographic and clinical characteristics, and radiological findings.ResultsWe identified 16 patients with PRES. The most common clinical presentation was seizure (n = 12, 75%). Clinical recovery occurred in all patients within days (mean, 5.7 ± 4.6 days). Comorbid conditions included hypertension (n = 4, 25%), cytotoxic medications (n = 3, 18.8%), sepsis (n = 4, 25%), malignancy (n = 4, 25%), subarachnoid hemorrhage (n = 1, 6.3%), autoimmune disorders (n = 1, 6.3%) and eclampsia (n = 1, 6.3%). The most commonly involved location was the parieto-occipital lobe (n = 13, 81.3%). Atypical radiological findings included significant basal ganglia involvement in 4 episodes; brainstem in 3, cerebellum in 2, and thalamus in 3. Eleven patients (68.8%) underwent diffusion-weighted imaging and apparent diffusion coefficient mapping. Of those, 9 patients (81.8%) had hypo- or isointensity on diffusion-weighted imaging. On the apparent diffusion coefficient map, 10 patients (90.9%) had hyperintensity, and the other had normal values.ConclusionWe suggest that PRES may occur in patients with complex systemic conditions. The prognosis of PRES is usually benign. Physicians should be aware of certain atypical radiological findings to avoid a delayed diagnosis of PRES, as delayed diagnosis and treatment can result in permanent neurological sequlae.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.